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Weight loss or weight gain is dependent on a number of factors, including diet, lifestyle, genetics and muscle mass. For those who choose medical transition, gender-affirming hormones – testosterone and oestrogen (and sometimes also progesterone) – can also have a direct impact on your nutritional needs.

Those undergoing medical transition may wish to improve their health, through diet and nutrition and knowing what values to measure and aim for can help to maintain focus.

 

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Men and women naturally have different physical values based on their body type, anatomical makeup, and fitness goals. These are often used to set the targets they are looking to achieve when embarking on a health improvement regime.

Values might include:

  • the number of calories they should consume (men 2,500, women 2,000, although this varies from person to person)
  • optimal measurements for e.g. waist, arms, waist, hips, chest
  • BMI (Body Mass Index), which takes gender into account

So how does a trans man know what to aim for in terms of optimal calorie intake, and how can a trans woman know what goal to set for waist measurement for example?

Despite an estimated 1% of the world’s population identifying as transgender, there are no official guidelines in relation to nutrition assessment for this group of individuals.

It’s important to know what kind of nutrition you need to properly support your transition, and make it easier to comfortably manage the changes in your body.

According to WPATH, the effects of gender-affirming hormones on physical make-up begin after 6–12 months, and the process takes between 2 and 5 years to complete.

Testosterone
With testosterone, If you gain weight, this fat will tend to go to the abdomen and mid-section, rather than the buttocks, hips and thighs, making the body look more masculine. You will also experience an increase in muscle mass and upper body strength

Oestrogen
Over time, oestrogen therapy will redistribute your body fat. Fat will collect around your hips and thighs and the muscles in your arms and legs will become less defined and have a smoother appearance as the fat just below your skin becomes a bit thicker. You can also expect your muscle mass and strength to decrease.

Progesterone
Progesterone influences weight in two ways; it increases the distribution of body fat and, at the same time, it increases protein breakdown.

An increase in body weight has been recorded in 0.1% to 1% of people on progesterone after 6 to 12 months of continuous use. This equates to around 2kg of weight gain. There have also been reports of weight loss but the frequency is unknown.

While the changes in physical shape will be welcomed by some, as it may sit with their vision of what constitutes their ideal masculine or feminine body type, the important thing is to stay healthy and be comfortable in your body.

With that in mind, what is the best way to measure progress towards your fitness goals, promote a healthier lifestyle, and work with your transition?

Know your numbers
One approach is to identify a range that sits somewhere between the male and female values.

If the estimated energy needs of a 30-year-old, 5 ft, 8 in. tall patient weighing 140 lbs. and classified as “low active” are 2,366 kcals/day for a cis woman and 2534 kcals/day for a cis man, the range for a transgender female or transgender male patient of the same height, weight, and activity level can be set between the two: 2366–2534 kcals/day.

Once the medical transition is underway (usually after 12 months) and hormone levels are within the normal ranges for a cis man or woman, you can switch to the nutritional values of a cis person of your height, weight, and activity levels.

Top tips for improved diet and nutrition
Whether you’re trying to lose weight, build muscle, or increase your body fat, these steps can be built into your lifestyle to improve your health.

Eat nuts and seeds
Add a handful into your diet for a protein-rich snack.

Avoid ultra-processed foods
Ultra-processed foods are foods containing ingredients that are significantly modified from their original form. They contain lower nutritional value than fresh fruits and vegetables or dried grains and pulses.

Drink water
Swap out your sugary drinks for water where you can. It’s free and will do a far better job at keeping you hydrated.

Eat a rainbow of fruit and veg
The more varied in colour your fruits and veg are the better, so mix it up!

Plan in advance
We tend to grab what’s easy. Plan the menu the week before and buy the necessary (healthy!) ingredients ahead of time.

Don’t like veg?
Hide it! Soups and pasta sauces can be a great way to disguise veggies if they just aren’t your thing.

Remember when it comes to nutrition, it doesn’t have to be all or nothing. You can factor in some good habits alongside your usual routine and it will have a positive impact on your overall health. The more you do, the bigger the impact!

 

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We are looking for experienced nutritionists with a proven track record to join our network. If, like us, you believe in taking a holistic approach to health and wellbeing and you share our commitment to making life easier for trans and non-binary people – and those who support them – we want to hear from you.

 

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